OBJECTIVES: To quantify the incremental detection rate of a targeted biopsy in addition to a randomized 10-core biopsy.
MATERIAL AND METHODS: This retrospective study analyzed 1024 patients who consecutively underwent a 4-core real time Elastography targeted biopsies (RTE) in addition to a randomized 10-core transrectal ultrasound (TRUS) guided biopsy in a primary or rebiopsy setting. Overall detection rate and detection rate of 10-core randomized, RTE guided biopsy and incremental detection rate have been calculated.
RESULTS: Overall, randomized and RTE targeted biopsies detection rates were 46.2 % (n=473), 39.1 %(n=400) and 29.0 % (n=297) for the combination, the 10 core and RTE-4 core biopsy scheme, respectively. RTE-4 core targeted biopsies found an additional 73 patients (increase in overall detection rate by 7.1%). Of those, 34 patients harbored significant Gleason 4 or 5 PCa, diagnosed by RTE-4 biopsy only. Moreover, PCa with a Gleason grade of 4 or 5 was detected by RTE-4 biopsies in 30 patients, who showed low grade PCa ≤ Gleason 3 only in systematic 10 core biopsy. These were not detected by the 10-core randomized biopsies. Therefore, RTE-4 core targeted biopsies incremented men diagnosed with PCA by 18.3%. Incremental detection rate was better in re-biopsy patients (24.8%) compared to patients having their first biopsy (14.7%).
CONCLUSIONS: RTE targeted biopsies seems to be an appropriate method to increase detection rate of PCA. Nevertheless, RTE targeted biopsies missed a high proportion of patients with PCA and should therefore be considered as an addition to randomized biopsies.
Written by:
Salomon G, Drews N, Autier P, Beckmann A, Heinzer H, Hansen J, Michl U, Schlomm T, Haese A, Steuber T, Graefen M, Becker A. Are you the author?
Martini-Clinic, Prostate Cancer Center Hamburg-Eppendorf, Hamburg, Germany.
Reference: BJU Int. 2013 Oct 15. Epub ahead of print.
doi: 10.1111/bju.12517
PubMed Abstract
PMID: 24128330
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